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Chronic wounds represent a major global health and economic burden. Smart wound dressings integrate biosensing and stimuli-responsive materials to monitor and modulate biological parameters within the wound microenvironment. This scoping review maps the biological parameters monitored by smart wound dressings, an area not previously synthesized across preclinical and clinical contexts. Following Joanna Briggs Institute (JBI) and PRISMA-ScR frameworks, five databases were searched in March 2025. Studies published between 2008 and 2025 reporting biosensing or responding technologies in wound dressings were included. A total of 179 studies met the inclusion criteria, most being preclinical (in vitro or in vivo rodent models), with few human investigations. The most frequently monitored parameters were pH, temperature, oxygenation, moisture, bacterial burden, and protease activity (particularly MMP-9). Preclinical data showed enhanced collagen deposition, angiogenesis, and infection control compared with conventional dressings, whereas human studies mainly assessed feasibility and biocompatibility. Smart dressings demonstrate strong technical and biological performance, but clinical validation and standardized outcome reporting remain limited. Future interdisciplinary research should prioritize well-designed clinical trials to confirm therapeutic and economic benefits and enable translation into personalized wound care.
by Dominika Buni, Áron Botond Kovács, Enikő Wehmann, Dénes Grózner, Krisztián Bányai, Eszter Zsófia Nagy, Janet Bradbury, Marco Bottinelli, Elisabetta Stefani, Salvatore Catania, Inna Lysnyansky, László Kovács, Miklós Gyuranecz, Zsuzsa Kreizinger
Mycoplasma iowae is an economically significant pathogen that causes reduced hatchability, late embryo mortality and leg deformities, chondrodystrophy and skeletal lesions in poults. While prevention is essential in the control of infection, the appropriate administration of antibiotics may reduce economic losses during outbreaks. As a first step in the exploration of antimicrobial resistance mechanisms in M. iowae, target modification and efflux pump activity were examined in the present study. Point mutations were analyzed in previously described antibiotic binding sites in the whole genome sequences of 99 M. iowae strains. Mismatch amplification mutation assays (MAMAs) were designed and validated for the differentiation of mutations corresponding to elevated minimum inhibitory concentration (MIC) values for fluoroquinolones. Broth microdilution assays were performed to evaluate the effect of efflux pump inhibitors. In the presence of orthovanadate (OV), MIC values were significantly lower than in the absence of OV for spiramycin, tilmicosin, tylosin and oxytetracycline, which may indicate the presence of an active efflux system in M. iowae. Putative promoter regions of efflux-related genes were predicted and characterized. Genetic mutations, previously described in other bacteria, were described to be associated with elevated fluoroquinolone, macrolide and lincomycin MICs in M. iowae, although certain resistant phenotypes remained unexplained, promoting future examinations for deeper insights. The developed MAMAs may support rapid identification of M. iowae strains with elevated MIC values for fluoroquinolones. The better understanding of the efflux pump mechanisms enables the development of alternative methods for the support of therapy against this pathogen.To explore the illness coping experiences of patients with moderate-to-severe burns and provide a reference for healthcare professionals to formulate coping strategies.
Qualitative study using a descriptive phenomenological approach.
From 1 June to 30 September 2024, semi-structured interviews were conducted with 19 patients with moderate-to-severe burns. Colaizzi's seven-step method was used for data analysis.
Seven subthemes and three higher order themes were identified: (1) perception of illness experience; (2) coping with disease threats; and (3) benefits of coping with illness. Most of the participants faced multiple difficulties in their disease experiences, such as increased financial pressure, higher pressure on family caregiving, deformed physical conditions and negative emotions. Positive psychological qualities, family and social support played significant roles in coping with these challenges.
Patients with moderate-to-severe burns experience multiple difficulties during their recovery. Effective coping resources can help them overcome these challenges.
Healthcare professionals should work with patients with moderate-to-severe burns and their families to establish an effective support system that enhances patients' coping abilities and promotes their overall recovery.
Patients with moderate-to-severe burns face diverse challenges. However, their experiences and coping processes during recovery remain unclear. This study provided valuable insights into their illness experiences and coping strategies. The findings highlighted multiple difficulties, such as a significant increase in financial pressure and dependence on family caregiving, painful and deforming physical conditions and various negative emotions. Positive psychological qualities, family and social support play an important role in coping with these challenges. Healthcare professionals should work with patients and their families to establish effective support systems to promote overall recovery.
No patient or public involvement.
Virtual scholarly events play an increasing role in doctoral education, particularly in nursing. The PhD Virtual Connect-event has been held annually for the past decade, evolving as a platform for engagement, knowledge exchange and professional development. However, its potential as a structured virtual Community of Practice remains underexplored.
This study explores the experiences of PhD students participating in the 9th and 10th editions (2023 and 2024) of the Sigma Theta Tau European Region's PhD Virtual Connect, examining how they perceive its alignment with Community of Practice principles and its role in doctoral nursing education.
A qualitative, open-ended survey was administered to the event participants who presented their studies across both editions, with responses being analysed using reflexive thematic analysis, followed by a comparative discussion of findings.
A total of 36 participants answered the survey. The analysis identified four key themes: developing a scholarly identity, reciprocity in feedback, structuring engagement and broadening research perspectives. Participants highlighted the event's role in strengthening academic confidence and fostering a sense of belonging. A shift towards peer-driven feedback and structured engagement in 2024 reflected increasing demand for organised discussions and thematic breakout sessions. These findings support the event's function as a dynamic Community of Practice, where participants co-construct knowledge, refine collaborative processes and navigate interdisciplinary learning.
The PhD Virtual Connect fosters scholarly engagement, mentorship and interdisciplinary exchange as an evolving virtual Community of Practice. While it sustains meaningful academic interaction, addressing digital inequities, enhancing interactive elements and formalising mentorship structures will be key to ensuring long-term inclusivity and engagement. Future research should examine the long-term impact of the virtual Community of Practice on academic career trajectories and professional networking in doctoral education.
No Patient or Public Contribution. This study focused on PhD nursing students' experiences in a virtual scholarly event, involving only academic participants. As it was not a healthcare intervention or service-related study, patient or public involvement was not applicable.
To investigate the professional dementia experts' understanding of a dementia-friendly hospital to identify its characteristics.
We used a qualitative design embedded in a case study. A total of 16 semi-structured expert interviews were conducted with 17 professional dementia experts. Using inductive content analysis, the interviews were analysed in a participatory manner involving a group of researchers and dementia experts.
We identified six characteristics of dementia-friendly hospitals: Proud to be dementia-friendly—That's what we want; Seeing the human being—Taking care of everyone; Having everyone on board—It's a collective task; Being professional—It takes more than being nice and kind; Rethinking the ‘running’ system—We have to change, not them; and Being part of the community—Thinking beyond the hospital.
The concept of a dementia-friendly hospital seems complex and requires a rethinking of the traditional hospital. For a conceptualisation, the involvement of people with dementia and their relatives is important to gain a comprehensive understanding.
A dementia-friendly hospital is characterised by professional care that comprises a safe, familiar and supportive environment, is prepared but also flexible, has everyone on board, and sees the human being. To become dementia-friendly, individual interventions such as training courses can be a starting point. However, an overall concept is required that also includes components that contribute to successful implementation and a welcoming culture of people with dementia.
Our findings on the perspective of professional dementia experts contribute to the conceptualisation of dementia-friendly hospitals.
We reported our study according to the COREQ checklist.
The investigation of the perspective of professional dementia experts is one part of a larger study. In this overall DEMfriendlyHospital study, we interviewed professional dementia experts, people with dementia and their relatives and also involved them in a participatory manner in various stages of the research process.
Breastfeeding provides well-documented benefits for both mothers and infants, yet global exclusive breastfeeding rates remain below target levels. Current research on lactation outcomes and challenges tends to focus on isolated factors, creating a fragmented evidence base. This scoping review aims to systematically map the existing literature on factors affecting lactation during the first 6 months post partum. We will develop and apply a Bio-Psycho-Social-Ecological (BPSE) integrative framework to organise the findings and identify gaps for future research.
We will conduct this scoping review following the updated Joanna Briggs Institute (JBI) methodology and report findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Systematic searches will be performed in PubMed, Cochrane Library, Scopus, Web of Science, CNKI, Wanfang and VIP databases. We will include systematic reviews, meta-analyses and randomised controlled trials published between January 2020 and October 2025. Two reviewers will independently screen articles and extract data. The extracted data will include study characteristics, trial registration status, examined factors or interventions and relevant lactation outcomes. Findings will be synthesised narratively and mapped within the BPSE framework.
Ethical approval is not required as this scoping review will synthesise data from publicly available publications. The findings will be disseminated through publication in a peer-reviewed journal and presentations at relevant academic conferences.
Open Science Framework https://doi.org/10.17605/OSF.IO/NXCRF.
To evaluate the impact of a 5-min delay in needle removal after haemodialysis on complications and patient satisfaction in newly created arteriovenous fistulas.
Retrospective cohort study.
This study analysed 109 patients with new arteriovenous fistulas undergoing initial cannulation 8–12 weeks post-surgery. Participants were divided into two cohorts: a conventional group (n = 42) receiving immediate needle removal after pump cessation, and a delayed group (n = 67) retaining needles for 5 min post-pump cessation before removal. Outcomes included haemostasis time, hematoma incidence, 3-month reintervention rates, and patient satisfaction measured by a 5-point scale.
Delaying needle removal by 5 min reduced mean haemostasis time by 32% compared to immediate removal (16.4 min vs. 24.1 min). Hematoma incidence decreased substantially by 76% in the delayed group (3.3% vs. 13.1%). At 3-month follow-up, reintervention rates were 66% lower with delayed removal (9.0% vs. 26.2%). Patients also reported 50% less procedure-related pain and significantly higher satisfaction scores (median 4.5 vs. 2).
A brief 5-min delay in needle removal significantly reduces complications and enhances patient-centered outcomes during early arteriovenous fistula use.
This protocol establishes an evidence-based standard for post-dialysis needle management, directly reducing compression-induced pain and reintervention needs while requiring no additional nursing resources. Implementation can immediately improve vascular access safety in haemodialysis units.
The study addresses high complication rates (26.2%) from immediate needle removal in immature fistulas. Key findings demonstrate 76% fewer hematomas and 66% lower reinterventions with 5-min delayed removal. This evidence may transform global haemodialysis nursing protocols, benefiting a substantial population of patients receiving new fistulas annually.
This study follows the STROBE checklist.
Patients and the public were not involved in the design, conduct, or reporting of this retrospective medical record analysis.
by Meshack Achore, Martine Hackett, Tatiana Ramirez
IntroductionCommunity health workers (CHWs) play a critical role in advancing health equity by bridging underserved communities with health and social services. However, expanding responsibilities, emotional labor, and fragmented service systems contribute to burnout. While prior research has examined CHW burnout in urban, rural, and crisis contexts, little is known about how burnout is experienced and mitigated in suburban settings characterized by geographic dispersion and administrative fragmentation. This study explored how CHWs in suburban Long Island, New York, experience emotional labor overload and the strategies they use, individually and organizationally, to prevent burnout.
MethodsWe conducted a qualitative descriptive study using purposive and snowball sampling and recruited 10 CHWs from Nassau and Suffolk counties in New York. Data were collected through ten semi-structured interviews and five participant observations. Participants were primarily women aged 35–44 years, most of whom (86%) worked in Nassau County and reported 2–5 years of experience. Transcripts were analyzed thematically using Braun and Clarke’s six-step framework in ATLAS.ti.
ResultsTwo overarching themes emerged: (1) Creating a healthy work-life balance, in which CHWs managed burnout by setting boundaries and practicing self-care; and (2) Building support structures in the workplace, where organizational supports such as supervision, peer collaboration, and ongoing training promoted resilience. Participants emphasized the importance of self-care rituals, spiritual grounding, and collegial networks as protective factors against emotional exhaustion.
ConclusionsBurnout among suburban CHWs is shaped by the interaction of individual coping practices and organizational conditions within fragmented service systems. Strengthening supervision, peer support infrastructure, and professional development opportunities may enhance workforce resilience and sustainability. Investments in organizational support structures are critical to sustaining CHWs’ capacity to promote health equity.
To assess public support and predictors of favourable or unfavourable views towards expanding Advanced Practice Nurse (APN) roles in Germany.
A quantitative, cross-sectional survey using Germany as a national case study.
Data came from the Politikpanel Deutschland, an online survey conducted 15–28 July 2024. After exclusions, 6733 respondents were included. Data were weighted by age, gender, federal state, and voting intention. Descriptive statistics, subgroup comparisons, and multinomial logistic regression were applied to analyse attitudes towards APNs, with results reported as average marginal effects and predicted probabilities.
Overall, 52.8% of respondents supported expanding APN roles, 25% opposed, and the remainder were undecided. Support was stronger among younger, male, and highly educated respondents, and those open to digital health technologies. Support was lower in East Germany and the city-states Berlin and Bremen, while it was higher in the south-west and north. Political ideology strongly predicted attitudes: supporters of right-wing parties were more likely to oppose, whereas left-leaning voters were more supportive.
Public support for expanding APN roles in Germany is moderate but uneven across demographic, regional, and political cohorts. Younger individuals and those favouring digital health technologies may drive future acceptance, while political resistance and regional disparities remain barriers.
This first, large-scale survey of German public attitudes towards APNs suggests that policymakers should (i) link APN role expansion with digital health innovations, (ii) address regional differences through tailored communication, and (iii) ensure that patients, physicians, and healthcare professionals perceive APN integration as enhancing, not diminishing primary care quality. Strengthening legal and educational frameworks and fostering collaboration between physicians and nurses will not only be essential to integrate APNs into Germany's healthcare system and, thereby, mitigate physician shortages, but also to foster public acceptance of APNs.
None.
CROSS-checklist.
Walking, as a simple, low-cost and easily implemented form of exercise, offers multiple health advantages. The WalkLung trial aims to evaluate the efficacy of a home-based walking exercise and education intervention in promoting early functional recovery after lung cancer surgery.
WalkLung is a multicentre, parallel-group, randomised controlled trial conducted at three hospitals in China, with stratification by study centre. A total of 116 patients with postoperative lung cancer will be randomised in a 1:1 ratio to either the intervention group (home-based walking exercise and education for 4 weeks) or the control group (usual care). The primary outcome is the longitudinal walking difficulty score during the 4-week postdischarge, measured by the validated perioperative symptom assessment for lung surgery scale (0–10 scale), assessed at discharge and weekly for 4 weeks. Secondary outcomes are the 6-min walk test, pulmonary function, complications, physical activity level, quality of life, social functioning, exercise adherence and adverse events. Long-term outcomes (up to 6 months) will be analysed and reported separately. All analyses will use an intention-to-treat approach, with outcome measures analysed as appropriate using generalised estimating equations for repeated measures, and t-tests or 2 tests.
Ethical approval was obtained from the Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital (No. SCCHEC-02-2025-091) and all participating subcentres. Written informed consent will be obtained from all participants. The manuscript is based on protocol V.1.0 (2 January 2025). The study findings will be disseminated through peer-reviewed journal publications and conference presentations.
ChiCTR2500103081.
To identify multifactorial contributors to treatment-seeking delays among Chinese young and middle-aged stroke patients using socioecological model.
Descriptive phenomenological interview study.
A tertiary hospital in China.
Twenty acute stroke patients with treatment-seeking delays and 16 family members were recruited for dyadic semistructured interviews.
Barriers influencing treatment-seeking delays across individual, interpersonal and systemic levels. And how do interlevel interactions shape decision-making trajectories?
Data analysis revealed 5 overarching themes encompassing 12 subthemes: (1) limited stroke-specific health literacy; (2) psychological barriers at symptom onset; (3) inadequate interpersonal support systems; (4) structural impediments to timely care; (5) decision-making dynamics across levels. Delay was characterised as a sequential cascade mediated by cognitive misattribution, emotional paralysis, relational dependency, institutional constraints and cross-level feedback loops. Two dominant pathways, silent progression and diverted seeking, were identified.
Treatment-seeking delay among young and middle-aged stroke patients arises through dynamic interactions across socioecological strata rather than isolated factors. Integrated interventions targeting public awareness, familial preparedness, workplace policies and healthcare accessibility are required to disrupt this cascade.
To consolidate the best evidence on digital therapeutic interventions for self-management in patients with hip fragility fractures, providing a foundational guide for clinicians in developing digital therapy-based self-management plans.
Integrative review.
A comprehensive electronic search was conducted across multiple databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Chinese databases like China National Knowledge Infrastructure and SinoMed. This study retrieved papers published from the establishment of the database to September 2023.
Studies were selected based on inclusion criteria, such as relevance to hip fragility fractures and self-management through digital therapies. Quality assessments were conducted independently by two reviewers using established tools for each type of study, ensuring the inclusion of high-quality evidence.
Fifteen studies were included: 4 guidelines, 5 expert consensus documents, 5 systematic reviews and 1 evidence summary. From these, 26 best practices were identified across 4 domains: digital design, self-management influencing factors, intervention plans and intervention content.
This integrative review provides a comprehensive, evidence-based summary of digital therapeutic interventions for self-management in patients with hip fragility fractures. The findings offer healthcare professionals a scientific basis for integrating digital therapy into clinical practice, highlighting its potential to enhance patient self-management.
This review underscores the value of digital therapies in empowering patients to take an active role in their rehabilitation, potentially improving adherence to self-management strategies and long-term outcomes.
No patient or public contribution was used for this study.
Split-thickness skin autografts are commonly used to treat extensive cutaneous defects. However, donor site morbidity, including pain, bleeding, and delayed epithelialization, remains a major clinical challenge. This study evaluates whether applying autologous platelet-rich plasma (PRP) to the donor site improves healing outcomes. A prospective cohort study was conducted at a tertiary-level academic hospital in Colombia. The study protocol was approved by the local Institutional Ethics Committee. Adult patients (> 18 years) undergoing split-thickness skin grafts for trauma, burns, oncologic resections, or chronic ulcers were included. Two groups were compared: the PRP group, in which autologous platelet-rich plasma was applied to the donor site, and the control group, which received standard wound care. The primary outcome was the quality of epithelialization at the donor site, while pain, assessed using the Numeric Rating Scale, was evaluated as a secondary outcome at multiple postoperative time points. Data were analysed using descriptive statistics and linear mixed-effects models adjusted for potential confounders, with statistical significance set at p < 0.05. A total of 46 patients were included (16 in the PRP group and 30 in the control group), with no significant demographic differences between groups. The PRP group demonstrated improved epithelialization quality, with lower Vancouver Scar Scale scores on postoperative days 7 and 14 (p < 0.05). Patients treated with PRP also reported a reduction of up to 50% in postoperative pain during early assessments (p < 0.001). These effects were maintained throughout the follow-up period, suggesting a sustained benefit of PRP on both healing quality and pain control. These findings suggest that autologous PRP application at split-thickness skin graft donor sites may enhance early epithelialization quality and reduce postoperative pain compared with standard wound care. PRP appears to be safe and may represent a useful adjunct to promote improved wound healing and patient recovery in reconstructive surgery. However, larger randomised controlled trials are required to confirm these findings and to establish the clinical effectiveness of autologous PRP in this setting.
by Xuying Zhang, Johanna Mainzer, Isabella Giambra, Tong Yin, Petra Engel, Hannah Hümmelchen, Henrik Wagner, Axel Wehrend, Christiane Egerer, Katharina Gerhards, Gerald Reiner, Sven König
Long tails trigger tail biting in pigs and increase the risk of flystrike infections in sheep. Tail docking has been a common management practice in both species for decades, but increasingly conflicts with legal animal welfare guidelines. Sustainable solutions require breeding strategies targeting shorter tails. In consequence, the aims were to conduct whole-genome sequencing (WGS)-based genome-wide association studies (GWAS) and comparative genomic analyses (CGA) to explore functional elements influencing tail traits. Phenotypically divergent experimental populations of pigs and sheep were established through unified selection and mating experiments. Tail traits included tail length (TL) measured at birth, and tail abnormalities (TA) assessed radiographically at 14 weeks of age. WGS-based GWAS identified a significant locus on SSC18 in pigs and suggestive loci for TL in both species, which, together with previously reported loci for TA, were further analyzed by CGA. The genomic windows of the significant locus on SSC18 in pigs and the TL GWAS locus on OAR4 in sheep were found to be conserved, harboring six common genes with predicted functional variants. These variants were jointly associated with TL (Plm ) in both species in linear regression models adjusted for sex, age of the dam, body length, and body weight. In other GWAS locus windows (±1 Mb), species-specific TL candidate genes were identified in sheep (HOXB13, MUC5B, EPB41L3, MTCL1, PIEZO2, MPPE1, and LOXHD1) and in pigs (KNL1, DISP2, SPRED1, TGFB2, and HAND1), each harboring associated putative functional variants. For TA, sheep-specific candidates (PGM2, LRRC66, CRACD, LOC105601916, and SH2D4B) and pig-specific candidates (MYOT, TMCO6, and PCDHAC2) were revealed using logistic regression models (Pglm ). GO analyses of candidate genes predicted shared biological processes between sheep and pigs, whereas pathway analyses indicated that common carbohydrate metabolism pathways, along with species-specific immune and inflammatory signaling, and pig-specific TGF-β signaling and endochondral ossification, may contribute to tail length variation and abnormalities. These findings provided deeper insights into the genetic basis of differential embryonic tail morphogenesis and perinatal tail development across species.Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.
FreshRSS 